Forbes: Why Early Wins Over Covid-19 Do Not Mean Victory: Canada’s Cautionary Tale

The following is an op-ed written by Jason Kindrachuk, an assistant professor in the department of medical microbiology & infectious diseases at UM, and a Canada Research Chair in molecular pathogenesis of emerging & re-emerging viruses. This article was originally published in Forbes on Nov. 4, 2020. 

Winnipeg, Canada has entered the Covid-19 red zone.  This is the highest level of risk in Manitoba Province, meaning there is widespread community transmission that is pushing the healthcare system to its threshold. The situation is precarious at best and devastating at worst. There has been an impending sense of dread building the last week, especially as case counts and fatalities have increased drastically.

This is a stark contrast to where things were just a few months ago as Covid-19 nearly started to take a backseat to other news stories and discussions amongst friends and family. This included a nearly two-week stretch with no new cases and reductions of active cases down to low single digits. The 5-day positivity rate difference pre-August and post-August tell the story of where we were and where the province now sits.  In the months leading up to this point there was an unsettling calm as life did actually start to feel like it had before the pandemic began. Now, there’s an urgent need to figure out how to get the case count back under control.

SARS-CoV-2, the virus that causes Covid-19, arrived in Manitoba on March 12th with the announcement of three presumptive cases that were all travel-related. By the start of April, the government moved to close non-critical businesses and schools as there were signs of community transmission. By mid-April, new cases had largely receded leaving a sense of near victory for the oncoming summertime. By June, there were no signs of ongoing community transmission and restrictions continued to be lifted. Public messaging continued to focus on the importance of distancing, masking and hygiene, but the province also introduced an initiative to try to kickstart the economy to help counter losses experienced by businesses and families during the prior months.

It was hard to not feel as if we had dodged something much larger and certainly there were numerous discussions around what Manitoba had done to do so well during the early stage of the pandemic. Indeed, by July 15th the test positivity rate was 0.16% across the province. It was also hard to not feel a sense of concern that our early experience with Covid-19 had perhaps left us unprepared for the reality of a much broader crisis if the virus was able to gain a foothold on our communities. Outbreaks in communal living areas were announced in July, as well as in the western region of the province, which includes the city of Brandon, and perhaps came as a quiet reminder that the virus was still with us. Underneath this, cases began to creep upwards in the capital city of Winnipeg.

There is one statistic that stands out today. From the first case of Covid-19 in the province up to the end of September, there had been 20 fatalities related to the virus. In the past four weeks that number has increased by 55 additional fatalities (75 as of November 1st). These fatalities have included 8 people under the age of 59.  The 5-day case positivity rate has increased to nearly 9% and active cases continue to increase. This has also pushed our healthcare system to its limits.

If one was to look at different indicators of an impending Covid-related crisis, we are certainly there. There are increasing hospitalizations, increasing fatalities, outbreaks in vulnerable communities and widespread community transmission. Recent Covid-19 data from the provincial government also provides context for the fact that severe and fatal disease impact both elderly and non-elderly age groups.

Vulnerable communities include our First Nations communities, where access to healthcare is a limiting factor, and whose communities saw far greater impacts during the 2009 H1N1 pandemic. They also include our long-term care facilities which have borne the heaviest burden of Canada’s Covid-related fatalities – nearly 80% of our fatalities. By October 30th, there were 15 outbreaks across long-term care facilities in the city of Winnipeg alone. The current situation is like trying to battle a raging wildfire with half a water can of water and a hope for rain. There are increasing calls for more resources to be allocated for this fight from community members and calls for an immediate increase in response efforts by healthcare professionals.

Cautious optimism in the face of a crisis

2020 has been a whirlwind on so many levels with Covid-19. It seems like a decade ago that I was reading about the identification of a new cluster of SARS-like illness in patients in Wuhan, China. I have been asked frequently the last few days of what went wrong in Manitoba and other regions of Canada and where do things go from here. I don’t have any easy answers for this.

Was there a lack of preparedness for an influx of cases? Was there too much optimism and complacency resulting from a perceived early victory over the virus that resulted in our guard being let down? Have we simply misjudged the nuances of this virus and how quickly it can exploit our vulnerabilities?

Right now, there is no choice but to figure a way out of this and time is of the essence. It will take the collective might of everyone in our communities–our healthcare workers, researchers, public health officials, politicians and, most importantly, our friends and neighbours. Perhaps the experience of Manitoba, and Winnipeg in particular, serves as a cautionary tale for other communities across the globe that had similar experiences early on in the pandemic.

Jason Kindrachuk, assistant professor at UM and Canada Research Chair